Difference of Low Skeletal Muscle Index According to Recommended Protein Intake in Korean

Background: Sarcopenia has become a major concern owing to its association with a high risk of fall or fracture and metabolic impairments. There is insufficient evidence to support the role of dietary protein intake in reducing the prevalence of sarcopenia. This study was conducted to investigate the variation in low skeletal muscle index (SMI) with the dietary levels of protein intake. Methods: This study analyzed data of 3,482 male and 4,838 female aged 50 years or older from the Korean National Health and Nutrition Examination Survey (KNHNES) database (2008–2011). Low SMI was indicated by a value <0.789 in male and <0.512 in female. Multiple logistic regression was performed to analyze the association of SMI with protein intake, whereby it was tested whether the dietary intake of proteins met the estimated average requirement (EAR) or the reference nutrient intake (RNI) as stated in the dietary reference intake (DRI) for Koreans, 2015. Results: Irrespective of sex, the prevalence of low SMI was significantly high when the protein intake did not meet the EAR or RNI. Following adjustment for covariates, the odds ratio (OR) for low SMI in subjects with unmet EARs was 1.63 (1.28–2.09) in male and 1.35 (1.10–1.66) in female. The OR for low SMI in subjects with unmet RNI was 1.74 (1.38–2.18) in male and 1.39 (1.14–1.69) in female. Conclusion: The prevalence of low SMI was significantly higher when the protein intake did not meet the EAR or RNI as stated in the DRI for Koreans.ope

Serum Low-Density Lipoprotein Cholesterol Levels and Depressive Mood in Korean Adults: A Nationwide Population-Based Study

Background: The association between serum cholesterol levels and depression has been studied extensively; however, results are inconsistent. This study aimed to investigate the association between low-density lipoprotein cholesterol (LDL-C) levels and depressive symptoms among Korean adults. Methods: This cross-sectional study used data obtained from the 2007-2015 Korea National Health and Nutrition Examination Survey. In total, 40,904 adults were included in the final analysis. Participants were categorized into five groups according to their LDL-C levels, using the Korean guidelines for dyslipidemia. Symptoms of depression were evaluated using a self-reported questionnaire. Weighted logistic regression was used to examine the relationship between LDL-C levels and self-reported depressive symptoms. Results: Compared with the intermediate category, the lowest (<70 mg/dL) and highest (≥160 mg/dL) LDL-C categories were associated with depressive symptoms, after adjusting for potential confounding factors (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.008-1.409; OR, 1.241; 95% CI, 1.073-1.435, respectively). The highest LDL-C category was positively associated with depressive symptoms in those who were middle-aged, female, had a low body mass index, and taking or not taking dyslipidemia medications. Conclusion: A U-shaped association was identified between LDL-C categories and self-reported depressive symptoms. Our findings suggest that LDL-C levels that are too low or too high are associated with self-reported depressive symptoms. Further prospective studies are needed to determine the causal relationship of this association.ope

Comparison of the triglyceride glucose (TyG) index, triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, and metabolic score for insulin resistance (METS-IR) associated with periodontitis in Korean adults

Background: Periodontitis is one of the most common diseases associated with the oral cavity. Previous studies have suggested that there is an association between periodontitis and metabolic dysfunction. Recently, the triglyceride glucose (TyG) index, high-density lipoprotein cholesterol (TG/HDL-C) ratio, and metabolic score for insulin resistance (METS-IR) index have been identified as useful markers for assessing insulin resistance. Objective: This study aimed to evaluate the relationship between periodontitis and non-insulin-based insulin resistance (IR) indices and compare the predictive values of these indices in the Korean population. Design: This is a cross-sectional study. Methods: A total of 13,584 participants were included in the 2013-2015 Korean National Health and Nutrition Examination Survey data. A community periodontal index score⩾3 was used to define periodontitis. Participants were divided into quartiles according to each index. Odds ratios (ORs) and 95% confidence intervals (CIs) for the prevalence of periodontitis and the TyG index, TG/HDL-C ratio, and METS-IR index quartiles were calculated using multiple logistic regression analysis. We estimated the areas under the receiver operating characteristic curves (AUCs) of the indices to compare the predictive values of the three indices. Results: Compared with quartile 1, the fourth quartile ORs (95% CIs) for periodontitis were 1.23 (1.01-1.49) for the TyG index, 1.23 (1.02-1.48) for the TG/HDL-C ratio, and 1.53 (1.25-1.88) for the METS-IR index after adjustment for confounders. The AUC (95% CIs) was 0.608 (0.598-0.618) for the TyG index, 0.600 (0.590-0.610) for the TG/HDL-C ratio, and 0.617 (0.608-0.627) for the METS-IR index to identify periodontitis. The predictive power of METS-IR was significantly higher than that of the TyG index and TG/HDL-C. Conclusion: Higher TG/HDL-C ratio, TyG, and METS-IR indices are associated with a higher prevalence of periodontitis. The METS-IR index is a more powerful predictor of periodontitis prevalence than the TyG index and TG/HDL-C ratio.ope

Association between oxidative balance score and new-onset hypertension in adults: A community-based prospective cohort study

Introduction: Oxidative stress plays a key role in the pathophysiology of hypertension development. The oxidative balance score (OBS) comprises dietary and lifestyle pro- and anti-oxidant components and reflects the overall oxidative stress burden. We aimed to evaluate the association between the OBS and new-onset hypertension (HTN) using large, community-based, prospective Korean cohort data. Methods: Among 10,030 participants aged 40-69 years included in the Korean Genome and Epidemiology Study, the data of 5,181 participants were analyzed. The hazard ratio (HR) and 95% confidence interval (CI) for new-onset HTN according to sex-specific OBS quartile groups were calculated using univariable and multivariable Cox proportional hazard regression analyses. Results: During the mean 13.6-year follow-up period, 1,157 men and 1,196 women developed new-onset HTN. Compared to the Q1 group, the adjusted HRs (95%CI) for new-onset HTN in the Q2, Q3, and Q4 groups were 0.96 (0.82-1.16), 0.85 (0.72-0.99), and 0.71 (0.59-0.86) in men and 0.81 (0.69-0.95), 0.81(0.68-0.95), and 0.70 (0.57-0.84) in women, respectively. Discussion: Individuals with high OBS are at lower risk of developing HTN. This study suggests that a healthy lifestyle and antioxidant rich diet could be a preventive strategy for HTN.ope

Association of non-high-density lipoprotein cholesterol trajectories with the development of non-alcoholic fatty liver disease: an epidemiological and genome-wide association study

Background: Non-alcoholic fatty liver disease (NAFLD) shares common risk factors with cardiovascular diseases. Effects of longitudinal trends in non-high-density lipoprotein (non-HDL) cholesterol on NAFLD development are not understood. This study aimed to assess the relationship between non-HDL cholesterol trajectories and the incidence of NAFLD and to identify genetic differences contributing to NAFLD development between non-HDL cholesterol trajectory groups. Methods: We analyzed data from 2203 adults (aged 40-69 years) who participated in the Korean Genome and Epidemiology Study. During the 6-year exposure periods, participants were classified into an increasing non-HDL cholesterol trajectory group (n = 934) or a stable group (n = 1269). NAFLD was defined using a NAFLD-liver fat score > -0.640. Multiple Cox proportional hazard regression analysis estimated the hazard ratio (HR) and the 95% confidence interval (CI) for the incidence of NAFLD in the increasing group compared with the stable group. Results: A genome-wide association study identified significant single-nucleotide polymorphisms (SNPs) associated with NAFLD. During the median 7.8-year of event accrual period, 666 (30.2%) newly developed NAFLD cases were collected. Compared with the stable non-HDL group, the adjusted HR (95% CI) for the incidence of NAFLD in the increasing non-HDL cholesterol group was 1.46 (1.25-1.71). Although there were no significant SNPs, the polygenic risk score was highest in the increasing group, followed by the stable and control groups. Conclusion: Our study indicates that lifestyle or environmental factors have a greater effect size than genetic factors in NAFLD progression risk. Lifestyle modification could be an effective prevention strategy for NAFLD for people with elevated non-HDL cholesterol.ope

Association between the Eating Family Meal and the Prevalence of Metabolic Syndrome Using Data from Korea National Health and Nutrition Examination Survey (2007-2012)

BACKGROUND: Several studies have shown that family meals promote a well-balanced and healthier diet and weight status. Metabolic syndrome is related to eating behavior. This study investigated the association between eating family meals and the prevalence of metabolic syndrome. METHODS: This cross-sectional study included 4,529 subjects who participated in the Korea National Health and Nutrition Examination Survey IV and V (2007-2012). A self-reported questionnaire was used to assess dietary status. Metabolic syndrome was defined according to the guidelines of the modified version of the National Cholesterol Education Program Adult Treatment Panel III. We compared the overall quality of dietary intake in family meal. RESULTS: Nutritional adequacy ratios for energy, protein, calcium, vitamin A, vitamin B1, vitamin B2, vitamin C, niacin, and potassium, and the mean adequacy ratio were significantly higher in the family meal group (P<0.05). The prevalence of metabolic syndrome was lower in the family meal group (P<0.05). However, we observed no significant association between eating family meals and the prevalence of metabolic syndrome. CONCLUSION: This study demonstrated that eating family meals appeared to be associated with nutrient adequacy. However, we observed no significant differences in prevalence of metabolic syndrome between the 2 groups

Corrected QT Interval is Associated with Nonalconolic Fatty Liver Disease in Korean Adult Men

Background: Recently, the incidence of nonalcoholic fatty liver disease (NAFLD) has been growing rapidly. Corrected QT (QTc) interval prolongation is known to be associated with the risk of coronary heart disease. In this study, our aim was to establish whether NAFLD diagnosed using ultrasonography is associated with QTc intervals in Korean adult men. Methods: We recruited 1,155 Korean adult men who visited the Gangnam Severance Hospital health promotion center between October 2007 and July 2010. The participants underwent liver ultrasonography according to a standardized protocol, which confirmed the diagnosis of NAFLD. Standard electrocardiography was performed for analysis of the QTc interval. Results: The 1,155 participants had a mean QTc interval of 430.7±21.2 ms. Of them, 366 had a QTc interval ≥440 ms. The values of the QTc interval increased in relation to the severity of NAFLD. After adjustment for confounders, QT interval prolongation was significantly associated with NAFLD in the severe NAFLD group. The odds ratios were 2.102 (95% confidence interval [CI] 1.536?2.877) (model 1), 1.986 (95% CI 1.399?2.819) (model 2), and 1.960 (95% CI 1.347?2.851) (model 3). Conclusion: QTc interval prolongation was significantly associated with NAFLD severity in Korean adult men. Depending on the severity of NAFLD, QTc intervals were prolonged. QTc interval length is easily determined and may contribute to cardiovascular risk stratification in male patients with NAFLD.ope

Relationship between Coffee Consumption and Metabolic Syndrome in Korean Adults: Data from the 2013-2014 Korea National Health and Nutrition Examination Survey

Background: The gradually increasing demand for coffee worldwide has prompted increased interest in the relationship between coffee and health issues as well as a need for research on metabolic syndrome in adults. Methods: Data from 3,321 subjects (1,268 men and 2,053 women) enrolled in the 2013-2014 Korean National Health and Nutrition Examination Survey were analyzed. The subjects were divided into three groups according to their daily coffee consumption. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for metabolic syndrome in the coffee-drinking groups were calculated using multiple logistic regression analysis by adjusting for confounding variables. Results: The prevalence of metabolic syndrome was 15.5%, 10.7%, and 9.7% in men and 3.0%, 7.1%, and 6.5% in women according to their coffee consumption (less than one, one or two, or more than three cups of coffee per day), respectively. Compared with the non-coffee consumption group, the ORs (95% CIs) for metabolic syndrome in the group that consumed more than three cups of coffee was 0.638 (0.328-1.244) for men and 1.344 (0.627-2.881) for women after adjusting for age, body mass index, household income, education, smoking, alcohol, regular exercise, and daily caloric intake. Conclusion: The OR of metabolic syndrome was not statistically significant in both men and women

한국 성인의 식생활평가지수와 치아우식증 유병률과의 관련성: 2013–2015 국민건강영양조사

Background: Dental caries is a chronic disease that is commonly seen in all age groups in Korea. Studies regarding the association between diet quality and dental caries are limited, and previous studies have focused only on children and adolescents. Therefore, we aimed to investigate the association between Korean Healthy Eating Index (HEI) and dental caries in Korean adults. Methods: Among 22,948 people who participated in the 2013–2015 Korea National Health and Nutrition Examination Survey, 10,365 adults aged ≥20 years were included in this study. The Korean HEI values were categorized into quartiles. Multiple logistic regression analysis was conducted to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for dental caries according to the HEI quartiles after adjusting for confounders. Results: The prevalence of dental caries significantly decreased with increasing HEI quartiles. When compared with quartile 4, the ORs and 95% CIs for dental caries were 1.364 (1.139–1.634) in quartile 1, 1.297 (1.097–1.533) in quartile 2, and 1.321 (1.107–1.577) in quartile 3 after adjusting for age, sex, body mass index, current smoking, alcohol consumption, physical activity, hypertension, diabetes, household income, education level, and tooth brushing before sleeping. Conclusion: Higher HEI value was significantly associated with lower prevalence of dental caries. Efforts to follow healthy diet habits could help in the prevention of dental caries in Korean adults.ope

Microalbuminuria as a simple predictor of incident diabetes over 8 years in the Korean Genome and Epidemiology Study (KoGES)

Microalbuminuria (MAU) is a common subclinical disease and related with cardiovascular outcome both in diabetic and non-diabetic patients. However, there is rare data about the effect of MAU on the development of diabetes. Thus, we aimed to investigate whether MAU is associated with the development of incident diabetes. A total of 3385 subjects without diabetes (1503 men and 1882 women; mean age, 53 years) who participated in the Ansung-Ansan cohort study from 2001-2002 (baseline) to 2011-2012 (fifth follow-up visit) were followed for a mean of 8 years. The prevalence of MAU at baseline was 10.8% (365 patients), and the incidence of newly developed diabetes during the follow-up period was 15.3% (56 patients) in subjects with MAU. The hazard ratio (HR) for development of diabetes was 1.43 (95% confidence interval (CI) 1.07-1.91, p-value 0.016), independent of traditional risk factors for diabetes including pre-diabetes, age, obesity, and family history. The impact of MAU on diabetes was also significant in the non-pre-diabetic population (HR 2.08, 95% CI 1.07-4.03, p-value 0.031). In conclusion, our results show that incident MAU is associated with future development of diabetes and could be an early marker for diabetes, even in the non-prediabetic population.ope